Chlorpromazine - Intramuscular

Chlorpromazine is used to treat schizophrenia (long-term mental disorder that causes changes in thoughts, feelings, and behaviour). It helps relieve symptoms common in schizophrenia, such as distorted thinking and emotional instability.

This medicine is also used to treat other mood disturbances such as bipolar disorder (mental condition that causes extreme mood changes between feeling very high [mania] and very low [depression]).

It may also be used to treat persistent hiccups, and nausea and vomiting associated with terminal illness.

Chlorpromazine may be used to treat other conditions as decided by your doctor.

Chlorpromazine injection is to be given intramuscularly (into the muscle, usually into the muscles of the upper arm, thigh or buttocks).

Your doctor or nurse will administer the injection for you.

Chlorpromazine intramuscular injection is given when you are not able to swallow pills or if you need urgent treatment for your condition. Your doctor will advise you about when you can switch from the injection to the pills.

Ensure that you keep all appointments with your doctor so that you do not miss any doses. Your doctor also needs to regularly monitor your response to Chlorpromazine.

If you miss an appointment or miss an injection, alert your doctor or nurse. A replacement appointment or injection should be given as soon as possible.

Alert your doctor if you have the following conditions:

• hypothyroidism (underactive thyroid gland)
• phaeochromocytoma (rare tumour of the adrenal gland causing high blood pressure)
• history of blood disorders
• glaucoma (increased pressure in the eye)
• urinary retention (inability to completely empty the bladder when urinating) due to prostate problem

as Chlorpromazine may not be suitable for you.

Do not breastfeed while you are being treated with this medicine.

Inform your doctor if you have the following conditions:

• myasthenia gravis (muscle weakness disorder)
• severe asthma or other respiratory diseases
• stomach problems e.g. pyloroduodenal obstruction (obstruction of the stomach outlet)
• diabetes
• Parkinson's disease (disorder that affects the movement of a person, causing symptoms such as tremors, muscle stiffness, slowed movement and impaired balance or walking)
• epilepsy (fits or seizures)
• disorders affecting the blood vessels and blood supply to the brain e.g. stroke
• heart problems
• kidney disease
• liver disease

Let your doctor know if you are pregnant.

Be sure to check with your doctor or pharmacist before giving Chlorpromazine to a child or to debilitated individual (physically or mentally weak, usually due to illness or old age). Children and debilitated individuals may be more sensitive to the side effects.

This medicine is not recommended in elderly patients with mood disorders related to dementia (a group of symptoms affecting thinking, memory, and social abilities).

If you are going to have certain laboratory tests (e.g. pregnancy test), inform your doctor that you are using Chlorpromazine.

Why is it important to keep my appointments with the doctor?

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.

• Routine tests (e.g. liver and kidney function, complete blood count; blood sugar, cholesterol, electrolyte and thyroid hormone levels, eye examination) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
• Regular monitoring of mental status, alertness, and signs of extrapyramidal symptoms and infection may also be needed.

What lifestyle changes should I make?

Chlorpromazine may affect the ability of your body to adjust to temperature changes in the environment. Avoid exposure to very cold or very hot environments. Avoid strenuous exercise and activities like going to the sauna. Drink more water to prevent dehydration.

Chlorpromazine may cause dizziness, drowsiness, or cause you to suddenly fall asleep during your daily activities such as eating and watching television. If affected, do not drive or take part in any activity in which you need to be alert.

This medicine may cause your blood pressure to fall suddenly when you get up from a sitting or lying down position and you may feel giddy. To minimise this problem, stand up slowly.

Other side effects include any of the following: nausea, constipation, fever, dry mouth, tiredness, blocked nose, difficulty in urination, confusion, and difficulty sleeping.

Chlorpromazine may also make your skin more sensitive to sunlight. Apply sunscreen when going outdoors and avoid prolonged exposure to sunlight and UV lamps.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• very bad headache, trembling, muscle stiffness or cramps, mental status changes
• irregular or abnormal heartbeat
• yellowing of the skin or eyes, abdominal pain, dark coloured urine, tiredness, swelling in the legs and ankles
• uncontrollable twitching movements of the mouth, tongue, and limbs, inability to stay still or restlessness
• fits or seizures
• feeling sleepy, frequent urination, fruity-smelling breath, unusual thirst or hunger
• enlarged breasts, nipple discharge, menstrual changes, inability of a man to attain or maintain an erection

This medicine may cause the level of your white blood cells and platelets to drop.

White blood cells help your body to fight infections. A fall in the level of your white blood cells may put you at higher risk for infections, such as coughs, colds and flu, which may lead to more serious infections. Avoid crowded places and people who are sick. Alert your doctor if you have a fever, cough, or flu that does not go away.

Platelets help your blood to clot when there is a cut in the skin. A fall in the level of your platelets may put you at risk of bleeding more than usual. Do not take part in activities where you may fall or get injured, such as contact sports. Alert your doctor if you get any unusual bruising (large bruises or several bruises, especially if the bruises appeared on their own) or bleeding that takes a long time to stop (for example, too much bleeding when you floss or brush your teeth).

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Inform your doctor and pharmacist if you are taking any of these medicines:

• medicines for irregular heartbeat e.g. quinidine, disopyramide, amiodarone, sotalol
• certain antibiotics e.g. moxifloxacin, ciprofloxacin
• medicines for anxiety e.g. citalopram, escitalopram
• medicines for fits or seizures e.g. phenytoin, carbamazepine, phenobarbital
• medicines for high blood pressure e.g. guanethidine, clonidine
• medicines used to treat Parkinson's disease e.g. levodopa, bromocriptine, amantadine

This list does not include all medicines that may interact with Chlorpromazine.

Always notify your doctor and pharmacist if you are using any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.

Avoid alcohol. Alcohol intake may worsen the dizziness and drowsiness caused by Chlorpromazine.

Store in a cool, dry place away from the reach of children. Protect from light.

Medicines must not be used past the expiry date.